Dual-phase versus single-phase helical CT to detect and assess resectability of pancreatic carcinoma

OBJECTIVE: The aim of this study was to compare dual-phase and single-phase helical CT for the detection and assessment of resectability of pancreatic adenocarcinoma. SUBJECTS AND METHODS: We studied 60 patients (31 men, 29 women; age range, 31-84 years; mean age, 62 years) with suspected pancreatic malignancy. Patients were randomly assigned to one of two groups. For group A (n = 30), unenhanced scans through the liver and pancreas were followed by two separate acquisitions (dual-phase) at 20-25 and at 60-80 sec after IV contrast administration. For group B (n = 30), unenhanced scans were followed by one set of scans (single-phase) acquired caudocranially (from the inferior hepatic margin to the diaphragm) starting 50 sec after IV contrast administration. Two observers independently scored images for the presence of tumor and for assessment of tumor resectability. RESULTS: Comparison of dual-phase versus single-phase helical CT for tumor detection showed a diagnostic accuracy for observer 1 of 87% and 90%, respectively, and for observer 2, of 90% and 87%, respectively. For both helical CT techniques, the overall agreement between the two observers was 83% (kappa = 0.73 +/- 0.03) for single-phase helical CT and 90% (kappa = 0.89 +/- 0.03) for dual-phase helical CT. The assessment of resectability was affected by the low number of resectable tumors (n = 8). CONCLUSION: Single-phase helical CT is effective for the diagnosis and assessment of resectability of patients with suspected pancreatic carcinoma. Advantages are the lower radiation dose and fewer images to film and store.